EP1327452A2 - Pharmaceutical compositions based on anticholinergically effective compounds and beta-mimetics - Google Patents
Pharmaceutical compositions based on anticholinergically effective compounds and beta-mimetics Download PDFInfo
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- EP1327452A2 EP1327452A2 EP03008310A EP03008310A EP1327452A2 EP 1327452 A2 EP1327452 A2 EP 1327452A2 EP 03008310 A EP03008310 A EP 03008310A EP 03008310 A EP03008310 A EP 03008310A EP 1327452 A2 EP1327452 A2 EP 1327452A2
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- A—HUMAN NECESSITIES
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/13—Amines
- A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
- A61K31/138—Aryloxyalkylamines, e.g. propranolol, tamoxifen, phenoxybenzamine
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- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/47—Quinolines; Isoquinolines
- A61K31/4748—Quinolines; Isoquinolines forming part of bridged ring systems
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- A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
- A61K31/137—Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine or methadone
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/16—Amides, e.g. hydroxamic acids
- A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
- A61K31/167—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/275—Nitriles; Isonitriles
- A61K31/277—Nitriles; Isonitriles having a ring, e.g. verapamil
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
- A61K31/4164—1,3-Diazoles
- A61K31/4184—1,3-Diazoles condensed with carbocyclic rings, e.g. benzimidazoles
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- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
- A61K31/425—Thiazoles
- A61K31/428—Thiazoles condensed with carbocyclic rings
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- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/439—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom the ring forming part of a bridged ring system, e.g. quinuclidine
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- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/46—8-Azabicyclo [3.2.1] octane; Derivatives thereof, e.g. atropine, cocaine
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- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
- A61K31/536—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines ortho- or peri-condensed with carbocyclic ring systems
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- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
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- A61P11/16—Central respiratory analeptics
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/007—Pulmonary tract; Aromatherapy
- A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
- A61K9/0075—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy for inhalation via a dry powder inhaler [DPI], e.g. comprising micronized drug mixed with lactose carrier particles
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- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/007—Pulmonary tract; Aromatherapy
- A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
- A61K9/0078—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy for inhalation via a nebulizer such as a jet nebulizer, ultrasonic nebulizer, e.g. in the form of aqueous drug solutions or dispersions
Definitions
- the present invention relates to novel drug compositions on the basis anticholinergic long-acting compounds and long-acting ⁇ -mimetics, Process for their preparation and their use in the therapy of Respiratory diseases.
- the main effects can be general restlessness, agitation, insomnia, anxiety, Finger shaking, sweats and headaches occur. This includes the By inhalation, these side effects do not matter, they are in general but slightly lower than after peroral or parenteral use.
- compositions according to the invention are ⁇ -mimetic formoterol or salmeterol, optionally in the form their racemates, their enantiomers, their diastereomers and their mixtures, as well as optionally their pharmacologically acceptable acid addition salts to Application.
- the long-acting ⁇ -mimetics in the form of their converted physiologically and pharmacologically acceptable salts and used become.
- the acid addition salts for example hydrochloric acid, Hydrobromic acid, sulfuric acid, phosphoric acid, methanesulfonic acid, Acetic acid, fumaric acid, succinic acid, lactic acid, citric acid, tartaric acid or maleic acid into consideration.
- mixtures of the aforementioned acids be used.
- the fumarate of formoterol (abbreviated formoterol FU) as long-acting ⁇ -mimetic preferred.
- the active ingredient formoterol as Enantiomeric or diastereomeric mixture or in the form of the individual Enantiomers / diastereomers are used.
- preferred as a long-acting ⁇ -mimetic Salmeterol Use, optionally in the form of its racemates, enantiomers of where the (R) -enantiomer is most preferred, and optionally its pharmacologically acceptable acid addition salts.
- the described anticholinergic agents may optionally be used in the form of the pure enantiomers, their mixture or racemates.
- Particularly preferred is tiotropium salt - especially the tiotropium bromide [(1 ⁇ , 2 ⁇ , 4 ⁇ , 5 ⁇ , 7 ⁇ ) -7 - [(hydroxy-2-thienylacetyl) oxy] -9,9-dimethyl-3-oxa-9-azoniatricyclo [ 3.3.1.0 2,4 ] nonan-bromide monohydrate - abbreviated tiotropium BR] - used as anticholinergic.
- alkyl groups (even if they are part of other radicals), as far as not otherwise defined, branched and unbranched alkyl groups having 1 to 4 Considered carbon atoms.
- methyl, ethyl, Propyl or butyl Unless otherwise stated, are from the above Propyl and butyl includes all of the possible isomeric forms.
- propyl includes the two isomeric groups n-propyl and iso-propyl, the term butyl n-butyl, iso-butyl, sec-butyl and tert-butyl.
- alkyl radicals also common abbreviations such as Me for methyl, Et for ethyl etc. used.
- alkoxy groups (even if they are part of other radicals), as far as not otherwise defined, branched and unbranched, via an oxygen atom considered bridged alkyl groups having 1 to 4 carbon atoms.
- propoxy and butoxy all of the possible isomeric forms includes.
- alkylene groups are branched and unbranched alkylene bridges with 4 to 6 Considered carbon atoms.
- butylene, pentylene, Hexylene Unless otherwise stated, are from the above Names of butylene, pentylene, hexylene all of the possible isomers Forms included.
- butylene includes the isomers n-butylene, 1-methylpropylene, 2-methylpropylene, 1,1-dimethylethylene, 1,2-dimethylethylene Etc.
- the halogen is generally fluorine, chlorine, bromine or iodine.
- anion X is, unless otherwise stated in general fluorine, chlorine, bromine, Iodine, methanesulfonate, fumarate, citrate.
- the active substance compositions according to the invention are preferably in the form of a Dosage aerosols administered - but it is also any other form of parenteral or oral administration possible.
- the application of Metered aerosols are the preferred form of application, especially in therapy obstructive pulmonary disease or in the treatment of asthma.
- Nebulizers are applied with which solutions of pharmacologically active substances be sprayed under high pressure so that mist of inhalable particles arise.
- the advantage of this nebulizer is that on the use of propellant gases can be completely dispensed with.
- the drugs intended for inhalation are in an aqueous state or ethanolic solution, depending on the solution properties of the Active substances and solvent mixtures of water and ethanol are suitable.
- nebulizers are disclosed, for example, in PCT patent application WO91 / 14468 and International Patent Application Serial No. PCT / EP96 / 04351 to which reference is hereby made.
- Respimat® are drug-containing solutions of defined volumes using high Prints sprayed through small nozzles, so that inhalable aerosols with a preferred particle size between 1 and 10, preferably between 2 and 5 Microns are created.
- solvents for the pharmaceutical preparation u.a.
- Suitable mixtures For example, contain ethanol as a solvent.
- Cosolvents also can the drug preparation flavors and contain further pharmacological adjuvants.
- cosolvents are those containing hydroxyl groups or other polar groups, for example Alcohols - especially isopropyl alcohol, glycols - especially propylene glycol, Polyethylene glycol, polypropylene glycol, glycol ethers, glycerol, polyoxyethylene alcohols and polyoxyethylene fatty acid esters.
- Cosolvents are suitable for solubility of excipients and optionally of the active ingredients.
- preservatives especially benzalkonium chloride
- benzalkonium chloride may be added.
- the preferred amount preservative, in particular benzalkonium chloride is between 8 and 12 mg / 100 ml solution.
- Chelating agents are added. Suitable complexing agents are those which are pharmacologically acceptable, especially those already are licensed under the drug law. Particularly suitable are EDTA, Nitrilotriacetic acid, citric acid and ascorbic acid as well as their salts. Particularly preferred is the disodium salt of ethylenediamtetraessigklare.
- the proportion of dissolved active ingredient combination in the finished pharmaceutical preparation is between 0.001 and 5%, preferably between 0.005 and 3%, in particular 0.01 to 2%.
- the maximum concentration of the drug is depending on the solubility in the solvent and the required dosage to achieve the desired therapeutic effect.
- the active compound combinations according to the invention can also be inhaled in the form of a powder.
- the preparation of such administration forms is known from the prior art.
- they contain pharmacologically acceptable carriers or excipients - such as, for example, microcrystalline lactose.
- the intended dose for inhalation can be filled into capsules, for example, and has, for example, the following composition: ingredients amount Tiotropium bromide hydrate 6 ⁇ g Formoterol fumarate x 2 H 2 O 6 ⁇ g Lactose monohydrate ad 25 mg
- Pentobarbital sodium (Nembutal®) is slowly injected intravenously.
- the animals are with 1.0 mg / kg i.v. Suxamethonium relaxes.
- the animals are ventilated with room air and oxygen (4: 1) using a 900 C Servo Ventilator (Siemens), frequency 15 / min., Respiratory volume 6 - 8 l / min.
- a dynamic pressure tube (meat no. 1), which is installed directly in front of the orotracheal tube, a DCB-4C differential pressure transducer and amplifier.
- One catheter is placed in the trachea and a second (balloon) catheter is placed in the lung portion of the esophagus. Both are connected to a differential pressure transducer and amplifier to determine the transpulmonary pressure.
- a respiratory mechanics computer IFD-Mühlheim
- VAS-1 LA IFD-Mühlheim
- ECG Extremity derivation II
- Cardiotachometer The registration of the heart rate takes place via ECG (extremity derivation II) and Cardiotachometer.
- test substances Tiotropium bromide, formoterol fumarate and the combination of both substances are administered as aqueous solutions with the BINEB nebulizer (Respimat®).
- the combination is applied with the individual components at a distance of about 1 min.
- the release mechanism takes place at the end of the Expiration phase and the atomized solution will be in the following Inspiration phase pressed by breath pump into the tracheobronchial tree.
- Tables 1 - 6 show the initial values and the values Substance treatment over the time of 180 min.
- figures 1 - 2 are the percent inhibitions of ACh-induced pulmonary Resistance increases over the time of 180 min. shown.
- Tiotropium bromide alone has no effect at both 3 ⁇ g and 10 ⁇ g on the heart rate.
- Formoterol FU enhances it in a dose-graded and pre-existing manner at most with the high dosage by more than 90%. Also at the end of the experiment Values of more than 80% are measured. With the combinations 3 + 3 ⁇ g, but Also 10 + 10 ⁇ g tiotropium bromide and formoterol fumarate are the Frequency effects significantly weakened and are less than 30%.
- Heart rate (beats / min.) control Minutes after application 1 5 10 20 30 60 120 180 66,50 79,00 75.00 75.00 77,00 79,00 74,00 75.00 70,00 87.50 96,00 91.00 88,00 89,00 90.00 85,00 83,00 83,00 86,50 85,00 80,00 79,00 77,00 76,00 75.00 76,00 87,00 109.50 104.00 102.00 101.00 101.00 101.00 103.00 103.00 105.00 110.50 102.00 102.00 102.00 101.00 96,00 101.00 102.00 101.00 85.50 76,00 75.00 76,00 77,00 74,00 73,00 74,00 74,00 Average 91.00 90.33 87.50 86.83 87,00 86,00 85.17 85.50 86.67 sem 6.80 4.89 5.17 5.00 4.82 4.60 5.61 5.53 5.75 10 ⁇ g
Abstract
Description
Die vorliegende Erfindung betrifft neurtige Arzneimittelkompositionen auf der Basis von anticholinergisch langwirksamen Verbindungen und langwirksamen β-Mimetika, Verfahren zu deren Herstellung und deren Verwendung bei der Therapie von Atemwegserkrankungen.The present invention relates to novel drug compositions on the basis anticholinergic long-acting compounds and long-acting β-mimetics, Process for their preparation and their use in the therapy of Respiratory diseases.
Aus dem Stand der Technik ist bekannt, daß β-Mimetika sowie Anticholinergika als Bronchospamolytika zur Behandlung obstruktiver Atemwegserkrankungen - wie z.B. des Asthmas - erfolgreich eingesetzt werden können. Stoffe mit β-sympathomimetischer Wirksamkeit - wie z.B. der ebenfalls aus dem Stand der Technik bekannte Wirkstoff Formoterol - können bei der Verabreichung am Menschen jedoch mit unerwünschten Nebenwirkungen verbunden sein.It is known from the prior art that β-mimetics and anticholinergics as Bronchospamolytics for the treatment of obstructive airway diseases - e.g. of asthma - can be successfully used. Substances with β-sympathomimetic Efficacy - e.g. also from the prior art known drug Formoterol - may be administered to humans however, be associated with undesirable side effects.
Als zentrale Wirkungen können allgemeine Unruhe, Erregung, Schlaflosigkeit, Angst, Fingerzittern, Schweißausbrüche und Kopfschmerzen auftreten. Dabei schließt die inhalative Anwendung diese Nebenwirkungen nicht aus, sie sind im allgemeinen jedoch etwas geringer als nach peroraler oder parenteraler Anwendung.The main effects can be general restlessness, agitation, insomnia, anxiety, Finger shaking, sweats and headaches occur. This includes the By inhalation, these side effects do not matter, they are in general but slightly lower than after peroral or parenteral use.
Die Nebenwirkungen der β-Sympathomimetika bei der Anwendung als Asthmamittel beruhen aber vor allem auf dem mehr oder weniger ausgeprägten β1-stimulierden Wirkungen am Herzen. Sie erzeugen Tachycardie, Herzklopfen, Angina-pectorisartige Beschwerden sowie Arrhytmien [P.T. Ammon (Hrsg.), Arzneimittelnebenwirkungen und -wechselwirkungen, Wissenschaftliche Verlagsgesellschaft, Stuttgart 1986,S. 584].The side effects of β-sympathomimetics when used as an asthma remedy but are based mainly on the more or less pronounced β1-stimulierden Effects on the heart. They produce tachycardia, palpitations, angina pectoris Complaints and arrhythmias [P.T. Ammon (ed.), Drug Side Effects and Interactions, Scientific Publishing Company, Stuttgart 1986, p. 584].
Überraschenderweise wurde nun gefunden, daß durch die Kombination eines langwirksamen β-Sympathomimetikmus mit einem langwirksamen Anticholinergikum die oben erwähnten Nebenwirkungen deutlich reduziert werden können.Surprisingly, it has now been found that by combining a long-acting β-sympathomimetics with a long-acting anticholinergic the above-mentioned side effects can be significantly reduced.
Völlig überraschend konnte dabei ebenfalls gefunden werden, daß sich die bronchospasmolytische Wirkung des langwirksamen Anticholinergikums und des langwirksamen β-Mimetikums in überadditiver Wirkung verstärken. Completely surprisingly could also be found that the bronchospasmolytic effect of the long-acting anticholinergic and the strengthen long-acting β-mimetics in over-additive action.
Mit der erfindungsgemäßen Wirkstoffkombination kann somit eine deutlich verbesserte Wirksamkeit - gegenüber den aus dem Stand der Technik bekannten Einzelsubstanzen und Kombinationen - sowohl bei COPD als auch bei Asthma erwartet werden.Thus, with the combination of active substances according to the invention a clear improved effectiveness - compared to those known from the prior art Individual substances and combinations - both in COPD and in asthma to be expected.
Als langwirksame β-Mimetika können in der erfindungsgemäßen
Wirkstoffkombination vorzugsweise folgende Wirkstoffe eingesetzt werden:
Bambuterol, Bitolterol, Carbuterol, Clenbuterol, Fenoterol, Formoterol, Hexoprenalin,
Ibuterol, Pirbuterol, Procaterol, Reproterol, Salmeterol, Sulfonterol, Terbutalin,
Tolubuterol, 4-Hydroxy-7-[2-{[2-{[3-(2-phenylethoxy)propyl]sulfonyl}ethyl]-amino}ethyl]-2(3H)-benzothiazolon,
Bevorzugt werden als langwirksame β-Mimetika in der erfindungsgemäßen
Wirkstoffkombination eingesetzt Formoterol, Salmeterol,
Besonders bevorzugt gelangen in den erfindungsgemäßen Arzneimittelkompositionen als β-Mimetikum Formoterol oder Salmeterol, gegebenenfalls in Form ihrer Racemate, ihrer Enantiomere, ihrer Diastereomere und ihrer Gemische, sowie gegebenenfalls ihrer pharmakologisch unbedenklichen Säureadditionssalze zur Anwendung.Particularly preferred are in the drug compositions according to the invention as β-mimetic formoterol or salmeterol, optionally in the form their racemates, their enantiomers, their diastereomers and their mixtures, as well as optionally their pharmacologically acceptable acid addition salts to Application.
Wie vorstehend genannt, können die langwirksamen β-Mimetika in Form ihrer physiologisch und pharmakologisch verträglichen Salze überführt und eingesetzt werden. Zur Darstellung der Säureadditionssalze kommen beispielsweise Salzsäure, Bromwasserstoffsäure, Schwefelsäure, Phosphorsäure, Methansulfonsäure, Essigsäure, Fumarsäure, Bernsteinsäure, Milchsäure, Zitronensäure, Weinsäure oder Maleinsäure in Betracht. Ferner können Mischungen der vorgenannten Säuren eingesetzt werden.As mentioned above, the long-acting β-mimetics in the form of their converted physiologically and pharmacologically acceptable salts and used become. For the preparation of the acid addition salts, for example hydrochloric acid, Hydrobromic acid, sulfuric acid, phosphoric acid, methanesulfonic acid, Acetic acid, fumaric acid, succinic acid, lactic acid, citric acid, tartaric acid or maleic acid into consideration. Furthermore, mixtures of the aforementioned acids be used.
Unter dem Blickwinkel der überadditiven bronchospasmolytischen Wirkung wird inbesondere das Fumarat des Formoterols (abgekürzt mit Formoterol FU) als langwirksames β-Mimetikum bevorzugt. - Dabei kann der Wirkstoff Formoterol als Enantiomeren- bzw. Diastereomerenmischung oder in Form der einzelnen Enantiomere/Diastereomere eingesetzt werden. Von erfindungsgemäß gleichrangig bevorzugter Bedeutung kann als langwirksames β-Mimetikum Salmeterol zum Einsatz kommen, gegebenenfalls in Form seiner Racemate, Enantiomere, von denen das (R)-Enantiomere höchst bevorzugt ist, sowie gegebenenfalls seiner pharmakologisch unbedenklichen Säureadditionssalze.From the perspective of superadditive bronchospasmolytic action is in particular, the fumarate of formoterol (abbreviated formoterol FU) as long-acting β-mimetic preferred. - In this case, the active ingredient formoterol as Enantiomeric or diastereomeric mixture or in the form of the individual Enantiomers / diastereomers are used. Of equal importance according to the invention preferred as a long-acting β-mimetic Salmeterol zum Use, optionally in the form of its racemates, enantiomers of where the (R) -enantiomer is most preferred, and optionally its pharmacologically acceptable acid addition salts.
Als langwirksame Anticholinergika eignen sich grundsätzlich bereits aus dem Stand der Technik bekannte Verbindungen, wie Glycopyrroniumbromid sowie Ester bi- und tricyclischer Aminoalkohole, wie sie aus der Europäischen Offenlegungsschrift 0 418 716 und der internationalen Patentanmeldung WO 92/16528 bekannt sind und auf die hiermit vollinhaltlich Bezug genommen wird. As long-acting anticholinergics are basically already from the state known in the art compounds such as glycopyrronium bromide and ester bi- and tricyclic amino alcohols, as disclosed in European Patent Publication 0 418 716 and the international patent application WO 92/16528 are known and which is hereby incorporated by reference.
Bevorzugt kommen im Rahmen der Erfindung als langwirksame Anticholinergika
Glycopyrroniumbromid sowie als Ester bi- und tricyclischer Aminoalkohole die
Verbindungen der Formel (I) in Betracht,
- A
- für einen Rest der allgemeinen Formel (II)
- Q
- eine der zweibindigen Gruppen -CH2-CH2-, -CH2-CH2-CH2-, -CH=CH-,
oder
- R
- ein gegebenenfalls halogen- oder hydroxysustituierter C1-C4-Alkylrest,
- R'
- ein C1-C4-Alkylrest bedeutet und R und R' gemeinsam auch einen
C4-C6-Alkylenrest bilden können,
und
der positiven Ladung des N-Atoms ein Äquivalent eines Anions X gegenübersteht, - Z
- für eine der Gruppen
worin
- Y
- eine Einfachbindung, ein O- oder S-Atom oder eine der Gruppen -CH2-, -CH2-CH2-, -CH=CH-, -OCH2- oder -SCH2- repräsentiert;
- R1
- Wasserstoff, OH, C1-C4-Alkoxy oder C1-C4-Alkyl, welches gegebenenfalls durch Hydroxy substituiert sein kann;
- R2
- ein Thienyl-, Phenyl-, Furyl-, Cyclopentyl- oder Cyclohexylrest, wobei diese Reste auch methylsubstituiert, Thienyl und Phenyl auch fluor- oder chlorsubstitueniert sein können,
- R3
- Wasserstoff oder ein Thienyl- oder Phenylrest, der gegebenenfalls durch Halogen oder C1-C4-Alkyl substituiert sein kann, bedeuten.
- A
- for a radical of the general formula (II)
- Q
- one of the divalent groups -CH 2 -CH 2 -, -CH 2 -CH 2 -CH 2 -, -CH = CH-, or
- R
- an optionally halogen- or hydroxysubstituted C 1 -C 4 -alkyl radical,
- R '
- a C 1 -C 4 -alkyl radical and R and R 'can together also form a C 4 -C 6 -alkylene radical,
and
the positive charge of the N atom is one equivalent of an anion X, - Z
- for one of the groups wherein
- Y
- represents a single bond, an O or S atom or one of the groups -CH 2 -, -CH 2 -CH 2 -, -CH = CH-, -OCH 2 - or -SCH 2 -;
- R 1
- Hydrogen, OH, C 1 -C 4 -alkoxy or C 1 -C 4 -alkyl, which may optionally be substituted by hydroxyl;
- R 2
- a thienyl, phenyl, furyl, cyclopentyl or cyclohexyl radical, these radicals also being methyl-substituted, and thienyl and phenyl also being fluorine- or chlorine-substituted,
- R 3
- Hydrogen or a thienyl or phenyl radical which may be optionally substituted by halogen or C 1 -C 4 alkyl, mean.
Besonders bevorzugt gelangen im Rahmen der Erfindung als lankgwirksame Anticholinergika Glycopyrroniumbromid sowie als Ester bi- und tricyclischer Aminoalkohole die Verbindungen der Formel (I) in Betracht, worin
- A
- für einen Rest der allgemeinen Formel (II)
in dem
- Q
- eine der zweibindigen Gruppen -CH = CH-, -CH2-CH2- oder
- R
- eine gegebenenfalls durch Fluor oder Hydroxy substituierte Methyl-, Ethyl, oder Propyl-Gruppe,
- R'
- Methyl, Ethyl oder Propyl, bevorzugt Methyl,
und
der positiven Ladung des N-Atoms ein Äquivalent eines Anions X ausgewählt aus der Gruppe bestehend aus Chlorid, Bromid und Methansulfonat, bevorzugt Bromid gegenübersteht, - Z
- für eine der Gruppen
worin
- Y
- eine Einfachbindung, oder ein O-Atom repräsentiert;
- R1
- Wasserstoff, OH, Methoxy, Ethoxy, Propoxy, Methyl, Ethyl, Propyl, Hydroxymethyl, Hydroxyethyl oder Hydroxyypropyl;
- R2
- ein Thienyl-, Phenyl-, oder Cyclohexylrest, wobei diese Reste auch methylsubstituiert, Thienyl und Phenyl auch fluor- oder chlorsubstituiert sein können,
- R3
- Wasserstoff, oder ein Thienyl- oder Phenylrest, der gegebenenfalls durch Fluor, Chlor oder Methyl substituiert sein kann, bedeuten,
- A
- for a radical of the general formula (II) in that
- Q
- one of the divalent groups -CH = CH-, -CH 2 -CH 2 - or
- R
- an optionally substituted by fluorine or hydroxy methyl, ethyl, or propyl group,
- R '
- Methyl, ethyl or propyl, preferably methyl,
and
the positive charge of the N atom is one equivalent of an anion X selected from the group consisting of chloride, bromide and methanesulfonate, preferably bromide, - Z
- for one of the groups wherein
- Y
- represents a single bond, or an O atom;
- R 1
- Hydrogen, OH, methoxy, ethoxy, propoxy, methyl, ethyl, propyl, hydroxymethyl, hydroxyethyl or hydroxypropyl;
- R 2
- a thienyl, phenyl, or cyclohexyl radical, these radicals also being methyl-substituted, thienyl and phenyl also being fluorine- or chlorine-substituted,
- R 3
- Is hydrogen, or a thienyl or phenyl radical which may optionally be substituted by fluorine, chlorine or methyl, mean
Erfindungsgemäß von besonderer Bedeutung sind Arzneimittelkompositionen, in denen als lankgwirksame Anticholinergika Verbindungen der Formel (I) Verwendung finden, worin
- A
- für einen Rest der allgemeinen Formel (II)
in dem
- Q
- eine der zweibindigen Gruppen -CH = CH-, -CH2-CH2- oder
- R
- Methyl oder Ethyl;
- R'
- Methyl,
und
der positiven Ladung des N-Atoms ein Äquivalent des Anions X = Bromid gegenübersteht, - Z
- für eine der Gruppen
worin
- Y
- ein O-Atom;
- R1
- Wasserstoff, OH oder Hydroxymethyl;
- R2
- ein Thienyl-, Phenyl-, oder Cyclohexylrest;
- R3
- Wasserstoff, Thienyl oder Phenylrest,
- A
- for a radical of the general formula (II) in that
- Q
- one of the divalent groups -CH = CH-, -CH 2 -CH 2 - or
- R
- Methyl or ethyl;
- R '
- Methyl,
and
the positive charge of the N atom is one equivalent of the anion X = bromide, - Z
- for one of the groups wherein
- Y
- an O atom;
- R 1
- Hydrogen, OH or hydroxymethyl;
- R 2
- a thienyl, phenyl, or cyclohexyl radical;
- R 3
- Hydrogen, thienyl or phenyl radical,
Von den vorstehend genannten Verbindungen sind im Rahmen der vorliegenden Erfindung die der 3-α-Konfiguration besonders bevorzugt.Of the above compounds are within the scope of the present invention Invention particularly preferred of the 3-α configuration.
Die beschriebenen anticholinergen Wirkstoffe können gegebenenfalls in Form der reinen Enantiomeren, deren Mischung bzw. Racemate eingesetzt werden. Besonders bevorzugt wird Tiotropium-Salz - insbesondere das Tiotropiumbromid [(1α,2β,4β,5α,7β)-7-[(Hydroxy-2-thienylacetyl)oxy]-9,9-dimethyl-3-oxa-9-azoniatricyclo[3.3.1.02,4]nonan-bromid Monohydrat - abgekürzt Tiotropium BR] - als Anticholinergikum eingesetzt.The described anticholinergic agents may optionally be used in the form of the pure enantiomers, their mixture or racemates. Particularly preferred is tiotropium salt - especially the tiotropium bromide [(1α, 2β, 4β, 5α, 7β) -7 - [(hydroxy-2-thienylacetyl) oxy] -9,9-dimethyl-3-oxa-9-azoniatricyclo [ 3.3.1.0 2,4 ] nonan-bromide monohydrate - abbreviated tiotropium BR] - used as anticholinergic.
Als Alkylgruppen (auch soweit sie Bestandteil anderer Reste sind) werden, soweit nicht anders definiert, verzweigte und unverzweigte Alkylgruppen mit 1 bis 4 Kohlenstoffatomen betrachtet. Beispielsweise werden genannt: Methyl, Ethyl, Propyl oder Butyl. Sofern nicht anders genannt, sind von den vorstehend genannten Bezeichnungen Propyl und Butyl sämtliche der möglichen isomeren Formen umfaßt. Beispielsweise umfaßt die Bezeichnung Propyl die beiden isomeren Reste n-Propyl und iso-Propyl, die Bezeichnung Butyl n-Butyl, iso-Butyl, sec. Butyl und tert.-Butyl. Gegebenfalls werden zur Bezeichnung der vorstehend genannten Alkylreste auch gängige Abkürzungen wie Me für Methyl, Et für Ethyl etc. verwendet. As alkyl groups (even if they are part of other radicals), as far as not otherwise defined, branched and unbranched alkyl groups having 1 to 4 Considered carbon atoms. For example: methyl, ethyl, Propyl or butyl. Unless otherwise stated, are from the above Propyl and butyl includes all of the possible isomeric forms. For example, the term propyl includes the two isomeric groups n-propyl and iso-propyl, the term butyl n-butyl, iso-butyl, sec-butyl and tert-butyl. Optionally, to denote the above-mentioned alkyl radicals also common abbreviations such as Me for methyl, Et for ethyl etc. used.
Als Alkoxygruppen (auch soweit sie Bestandteil anderer Reste sind) werden, soweit nicht anders definiert, verzweigte und unverzweigte, über ein Sauerstoffatom verbrückte Alkylgruppen mit 1 bis 4 Kohlenstoffatomen betrachtet. Beispielsweise werden genannt: Methoxy, Ethoxy, Propoxy (=Propyloxy) oder Butoxy (=Butyloxy). Auch hier sind, sofern nicht anders genannt, von den vorstehend genannten Bezeichnungen Propoxy und Butoxy sämtliche der möglichen isomeren Formen umfaßt.As alkoxy groups (even if they are part of other radicals), as far as not otherwise defined, branched and unbranched, via an oxygen atom considered bridged alkyl groups having 1 to 4 carbon atoms. For example are called: methoxy, ethoxy, propoxy (= propyloxy) or butoxy (= butyloxy). Again, unless otherwise stated, from the above Designations of propoxy and butoxy all of the possible isomeric forms includes.
Als Alkylengruppen werden verzweigte und unverzweigte Alkylenbrücken mit 4 bis 6 Kohlenstoffatomen betrachtet. Beispielsweise werden genannt: Butylen, Pentylen, Hexylen. Sofern nicht anders genannt, sind von den vorstehend genannten Bezeichnungen Butylen, Pentylen, Hexylen sämtliche der möglichen isomeren Formen umfaßt. Beispielsweise umfaßt die Bezeichnung Butylen die Isomeren n-Butylen, 1-Methylpropylen, 2-Methylpropylen, 1.1-Dimethylethylen, 1.2-Dimethylethylen etc.As alkylene groups are branched and unbranched alkylene bridges with 4 to 6 Considered carbon atoms. For example: butylene, pentylene, Hexylene. Unless otherwise stated, are from the above Names of butylene, pentylene, hexylene all of the possible isomers Forms included. For example, the term butylene includes the isomers n-butylene, 1-methylpropylene, 2-methylpropylene, 1,1-dimethylethylene, 1,2-dimethylethylene Etc.
Als Halogen wird im allgemeinen Fluor, Chlor, Brom oder Jod bezeichnet.The halogen is generally fluorine, chlorine, bromine or iodine.
Als Anion X wird, soweit nicht anders genannt im allgemeinen Fluor, Chlor, Brom, Jod, Methansulfonat, Fumarat, Citrat bezeichnet.As anion X is, unless otherwise stated in general fluorine, chlorine, bromine, Iodine, methanesulfonate, fumarate, citrate.
Die erfindungsgemäßen Wirkstoffkompositionen werden vorzugsweise in Form eines Dosierungsaerosols verabreicht - es ist aber auch jede andere Form der parenteralen oder oralen Applikation möglich. Dabei verkörpert die Anwendung von Dosieraerosolen die bevorzugte Anwendungsform insbesondere bei der Therapie obstruktiver Lungenerkrankungen oder bei der Behandlung des Asthmas.The active substance compositions according to the invention are preferably in the form of a Dosage aerosols administered - but it is also any other form of parenteral or oral administration possible. The application of Metered aerosols are the preferred form of application, especially in therapy obstructive pulmonary disease or in the treatment of asthma.
Neben der Anwendung in Dosieraerosolen, die auf der Basis von Treibgasen arbeiten, können die erfindungsgemäßen Wirkstoffkombinationen mittels sog. Verneblern appliziert werden, mit denen Lösungen pharmakologisch aktiver Stoffe unter hohem Druck so versprüht werden, daß Nebel inhalierbarer Teilchen entstehen. Der Vorteil dieser Vernebler ist, daß auf den Einsatz von Treibgasen völlig verzichtet werden kann.In addition to the use in metered dose aerosols based on propellant gases work, the active compound combinations according to the invention by means of so-called. Nebulizers are applied with which solutions of pharmacologically active substances be sprayed under high pressure so that mist of inhalable particles arise. The advantage of this nebulizer is that on the use of propellant gases can be completely dispensed with.
Überlicherweise sind die zur Inhalation bestimmten Arzneistoffe in einer wässerigen oder ethanolischen Lösung gelöst, wobei je nach den Lösungseigenschaften der Wirkstoffe auch Lösungsmittelgemische aus Wasser und Ethanol geeignet sind. Usually, the drugs intended for inhalation are in an aqueous state or ethanolic solution, depending on the solution properties of the Active substances and solvent mixtures of water and ethanol are suitable.
Derartige Vernebler sind beispielsweise in der PCT-Patentanmeldung WO91/14468 und in der internationalen Patentanmeldung mit dem Aktenzeichen PCT/EP96/04351 beschrieben, auf die hiermit inhaltlich Bezug genommen wird. Bei den dort beschriebenen Verneblern, die auch unter der Bezeichnung Respimat® bekannt sind, werden wirkstoffhaltige Lösungen definierter Volumina unter Anwendung hoher Drucke durch kleine Düsen versprüht, so daß inhalierbare Aerosole mit einer bevorzugten Teilchengröße zwischen 1 und 10, bevorzugt zwischen 2 und 5 Mikrometer entstehen.Such nebulizers are disclosed, for example, in PCT patent application WO91 / 14468 and International Patent Application Serial No. PCT / EP96 / 04351 to which reference is hereby made. At the there described nebulizers, also known as Respimat® are drug-containing solutions of defined volumes using high Prints sprayed through small nozzles, so that inhalable aerosols with a preferred particle size between 1 and 10, preferably between 2 and 5 Microns are created.
Als Lösungsmittel für die Arzneimittelzubereitung sind u.a. Gemische geeignet, die beispielsweise Ethanol als Lösungsmittel enthalten.As solvents for the pharmaceutical preparation u.a. Suitable mixtures For example, contain ethanol as a solvent.
Weitere Bestandteile des Lösungsmittels sind neben Wasser gegebenenfalls weitere Cosolventien, ebenfalls kann die Arzneimittelzubereitung Geschmackstoffe und weitere pharmakologische Hilfsstoffe enthalten. Beispiele für Cosolventien sind solche, die Hydroxylgruppen oder andere polare Gruppen enthalten, beispielsweise Alkohole - insbesondere Isopropylalkohol, Glykole - insbesondere Propylenglykol, Polyethylenglykol, Polypropylenglykol, Glykolether, Glycerol, Polyoxyethylenalkohole und Polyoxyethylen-Fettsäureester. Cosolventien sind dazu geeignet, die Löslichkeit von Hilfsstoffen und gegebenenfalls der Wirkstoffe zu erhöhen.Further constituents of the solvent are optionally further apart from water Cosolvents, also can the drug preparation flavors and contain further pharmacological adjuvants. Examples of cosolvents are those containing hydroxyl groups or other polar groups, for example Alcohols - especially isopropyl alcohol, glycols - especially propylene glycol, Polyethylene glycol, polypropylene glycol, glycol ethers, glycerol, polyoxyethylene alcohols and polyoxyethylene fatty acid esters. Cosolvents are suitable for solubility of excipients and optionally of the active ingredients.
Weitere pharmakologische Hilfsstoffe wie beispielsweise Konservierungsmittel insbesondere Benzalkoniumchlorid, können zugesetzt sein. Die bevorzugte Menge an Konservierungsstoff, insbesondere an Benzalkoniumchlorid liegt zwischen 8 und 12 mg/100 ml Lösung.Other pharmacological adjuvants such as preservatives especially benzalkonium chloride may be added. The preferred amount preservative, in particular benzalkonium chloride is between 8 and 12 mg / 100 ml solution.
Zur Vermeidung von Sprühanomalien können der Wirkstoffkombination Komplexbildner zugesetzt werden. - Geeignete Komplexbildner sind solche die pharmakologisch verträglich sind, insbesondere solche die bereits arzneimittelrechtlich zugelassen sind. Besonders geeignet sind EDTA, Nitrilotriessigsäure, Zitronensäure und Ascorbinsäure wie auch deren Salze. Besonders bevorzugt ist das Dinatriumsalz der Ethylendiamtetraessigsäure.To avoid spray anomalies may be the drug combination Chelating agents are added. Suitable complexing agents are those which are pharmacologically acceptable, especially those already are licensed under the drug law. Particularly suitable are EDTA, Nitrilotriacetic acid, citric acid and ascorbic acid as well as their salts. Particularly preferred is the disodium salt of ethylenediamtetraessigsäure.
Der Anteil der gelösten Wirkstoffkombination an der fertigen Arzneimittelzubereitung beträgt zwischen 0.001 und 5 % - vorzugsweise zwischen 0.005 und 3 %, insbesondere 0.01 bis 2 %. Die maximale Konzentration des Arzneistoffes ist abhängig von der Löslichkeit im Lösungsmittel und von der erforderlichen Dosierung zur Erzielung der gewünschten therapeutischen Wirkung. The proportion of dissolved active ingredient combination in the finished pharmaceutical preparation is between 0.001 and 5%, preferably between 0.005 and 3%, in particular 0.01 to 2%. The maximum concentration of the drug is depending on the solubility in the solvent and the required dosage to achieve the desired therapeutic effect.
Folgende Zubereitungsformen seien als Formulierungsbeispiel angeführt:
in mg/100 ml
in mg/100 ml
in mg / 100 ml
in mg / 100 ml
Daneben können die erfindungsgemäßen Wirkstoffkombinationen auch in Form
eines Pulvers inhaliert werden. Die Herstellung derartiger Darreichungsformen ist
aus dem Stand der Technik bekannt. Sie enthalten neben der Wirkstoffkombination
entsprechend der vorliegenden Erfindung pharmakologisch unbedenkliche Trägeroder
Hilfsstoffe - wie z.B. mikrokristalline Lactose. Die zur Inhalation vorgesehene
Dosis kann beispielsweise in Kapseln abgefüllt werden und hat z.B. folgende
Zusammensetzung:
Bronchospasmolytische und kardiovaskuläre Wirkung von Tiotropiumbromid, Formoterolfumarat sowie deren Kombination nach inhalativer Applikation wäßriger Lösung mittels Respimat® an narkotisierten Hunden.Bronchospasmolytic and cardiovascular effects of tiotropium bromide, Formoterolfumarat and their combination after inhalation aqueous Solution using Respimat® on anesthetized dogs.
18 mischrassige Hunde mit einem Körpergewicht von 27 bis 32 kg. Haltung in Einzel- bzw. Sammelboxen, pelletiertes Standardfutter, letzte Fütterung ca. 15 Stunden vor Versuchsbeginn, Tränkewasser ad libitum.18 mixed breed dogs with a body weight of 27 to 32 kg. Attitude in individual or collection boxes, pelleted standard feed, last feeding about 15 hours before Start of the experiment, drinking water ad libitum.
Nach Prämedikation mit 2 mg/kg Morphinhydrochlorid i.m. werden 30 mg/kg Pentobarbital-Natrium (Nembutal®) langsam intravenös injiziert. Die Tiere sind mit 1,0 mg/kg i.v. Suxamethonium relaxiert.After premedication with 2 mg / kg morphine hydrochloride i.m. be 30 mg / kg Pentobarbital sodium (Nembutal®) is slowly injected intravenously. The animals are with 1.0 mg / kg i.v. Suxamethonium relaxes.
Die Tiere werden nach den Intubationen mittels eines Servo-Ventilators 900 C (Fa.
Siemens) mit Raumluft und Sauerstoff (4:1) beatmet, Frequenz 15/min.,
Atemvolumen 6 - 8 l/min. Für die Registrierung der Atemmechanik wird der Atemfluß
mittels Staudruckrohr (Fleisch Nr. 1), das unmittelbar vor dem Orotrachealtubus
installiert ist, einem Differentialdruckaufnehmer und -verstärker DCB-4C bestimmt.
Ein Katheter wird in der Trachea und ein zweiter (Ballon-)Katheter im
Lungenabschnitt des Oesophagus plaziert. Beide werden verbunden mit einem
Differenzialdruckaufnehmer und -verstärker zur Bestimmung des transpulmonalen
Druckes. Ein Atemmechanik-Rechner (IFD-Mühlheim) ermittelt aus den registrierten
Druckwerten den pulmonalen Widerstand (R). Ein Computerprogramm VAS-1 LA
(IFD-Mühlheim) bestimmt daraus:
Die Registrierung der Herzfrequenz erfolgt über EKG (Extremitätenableitung II) und Kardiotachometer.The registration of the heart rate takes place via ECG (extremity derivation II) and Cardiotachometer.
Nach einer Aquilibrierungsperiode von 30 min. werden kurzfristige Bronchospasmen durch i.v. Injektion von 10 µg/kg Acetylcholinchlorid erzeugt, die 2 - 3 x innerhalb eines ca. 10 min. Abstands wiederholt werden. Die Testsubstanzen Tiotropiumbromid, Formoterolfumarat sowie die Kombination beider Substanzen werden als wässrige Lösungen mit dem BINEB-Zerstäuber (Respimat®) verabreicht. Die Applikation der Kombination erfolgt mit den Einzelkomponenten in Abstand von ca. 1 min. Bei dem BINEB-System erfolgt der Auslösemechanismus am Ende der Exspirationsphase und die zerstäubte Lösung wird in der folgenden Inspirationsphase per Atempumpe in den Tracheobronchialbaum gedrückt.After an equilibration period of 30 min. become short-term bronchospasm by i.v. Injection of 10 μg / kg of acetylcholine chloride generated 2-3 times within one about 10 minutes Distance be repeated. The test substances Tiotropium bromide, formoterol fumarate and the combination of both substances are administered as aqueous solutions with the BINEB nebulizer (Respimat®). The combination is applied with the individual components at a distance of about 1 min. In the BINEB system, the release mechanism takes place at the end of the Expiration phase and the atomized solution will be in the following Inspiration phase pressed by breath pump into the tracheobronchial tree.
Die Tabellen 1 - 6 zeigen die Ausgangswerte und die Werte nach Substanzbehandlung über die Zeit von 180 min. In den Abbildungen 1 - 2 sind die prozentualen Hemmungen der durch ACh-induzierten pulmonalen Widerstandserhöhungen über die Zeit von 180 min. dargestellt.Tables 1 - 6 show the initial values and the values Substance treatment over the time of 180 min. In figures 1 - 2 are the percent inhibitions of ACh-induced pulmonary Resistance increases over the time of 180 min. shown.
Die Ergebnisse sind in den Tabellen sowie in den Abbildungen dargestellt. 3 und 10 µg Tiotropium Bromid bzw. Formoterolfumarat hemmen den durch intravenöse Injektion von ACh erhöhten Bronchialwiderstand dosisabgestuft und deutlich. Die maximale bronchospasmolytische Wirkung von Formoterol FU tritt mit beiden Dosierungen rasch ein, die von Tiotropium BR verzögert etwa nach 60 min. Die Wirkdauer von Formoterol FU ist vor allem mit den niedrigen Dosierungen verhältnismäßig kurz, die des Tiotropium BR erwartungsgemäß, bis zum Versuchsende (180 min.), anhaltend.The results are shown in the tables and figures. 3 and 10 μg tiotropium bromide or formoterol fumarate inhibit the by intravenous Injection of ACh increased dose-graded and marked bronchial resistance. The maximum bronchospasmolytic effect of Formoterol FU occurs with both Dosages rapidly, which is delayed by tiotropium BR after about 60 min. The The duration of action of Formoterol FU is mainly with the low dosages relatively short, that of tiotropium BR as expected, until End of the experiment (180 min.), Persistent.
Mit der Kombination von 3 µg Tiotropium Bromid + 3 µg Formoterol FU wird eine ausgeprägte, sehr schnell einsetzende Bronchospasmolyse von 90 % erzielt, die bis zum Versuchsende nahezu unverändert anhält. Die protektive Wirkung der Kombination übertrifft die der Einzelkomponenten überaus deutlich, aber auch die Summe der Einzeleffekte vonWith the combination of 3 μg tiotropium bromide + 3 μg formoterol FU becomes a pronounced, very rapid onset bronchospasmolysis of 90% achieved until at the end of the test almost unchanged. The protective effect of Combination surpasses that of the individual components very clearly, but also the Sum of the individual effects of
3 µg Tiotropium Bromid und 3 µg Formoterol FU. Sie übertrifft, die Effekte von 10 µg Tiotropium Bromid bzw. 10 µg Formoterol Fumarat (vgl. Abbildung 2).3 μg tiotropium bromide and 3 μg formoterol FU. It surpasses the effects of 10 μg Tiotropium bromide or 10 μg formoterol fumarate (see Figure 2).
Tiotropium Bromid alleine hat sowohl mit 3 µg als auch mit 10 µg keinerlei Einfluß auf die Herzfrequenz. Formoterol FU steigert sie hingegen dosisabgestuft und vor allem mit der hohen Dosierung maximal um über 90 %. Auch am Versuchsende werden noch Werte von über 80 % gemessen. Mit den Kombinationen 3 + 3 µg, aber auch 10 + 10µg Tiotropium Bromid und Formoterol Fumarat sind die Frequenzeffekte deutlich abgeschwächt und liegen unter 30 %.Tiotropium bromide alone has no effect at both 3 μg and 10 μg on the heart rate. Formoterol FU, on the other hand, enhances it in a dose-graded and pre-existing manner at most with the high dosage by more than 90%. Also at the end of the experiment Values of more than 80% are measured. With the combinations 3 + 3 μg, but Also 10 + 10μg tiotropium bromide and formoterol fumarate are the Frequency effects significantly weakened and are less than 30%.
Mit der Kombination des Anticholinergikums mit dem β-Mimetikum werden
gegenüber den Einzelstoffen völlig überraschende Befunde erhoben:
Mit dem Kombinationspräparat kann eine deutlich verbesserte therapeutische Wirksamkeit sowohl bei COPD als auch bei Asthma erwartet werden, verbunden mit dem Vorteil der geringeren kardialen Nebenwirkungen. With the combination preparation can be a significantly improved therapeutic Efficacy associated with both COPD and asthma can be expected the advantage of lower cardiac side effects.
Fig. 1 zeigt den Einfluß von 3 µg Formoterol Fumarat, 3 µg Tiotropium Bromid sowie der Kombination 3 µg Tiotropium Bromid + 3 µg Formoterol Fumarat auf den Bronchialwiderstand narkotisierter Hunde, n = 6.Fig. 1 shows the influence of 3 ug formoterol fumarate, 3 ug tiotropium bromide and the combination of 3 μg tiotropium bromide + 3 μg formoterol fumarate on the Bronchial resistance of anaesthetized dogs, n = 6.
Fig. 2 zeigt den Einfluß von 10 µg Formoterol Fumarat, 10 µg Tiotropium Bromid sowie der Kombination 3 µg Tiotropium Bromid + 3 µg Formoterol Fumarat auf den Bronchialwiderstand narkotisierter Hunde, n = 6.Fig. 2 shows the influence of 10 ug formoterol fumarate, 10 ug tiotropium bromide and the combination of 3 μg tiotropium bromide + 3 μg formoterol fumarate on the Bronchial resistance of anaesthetized dogs, n = 6.
Claims (13)
- A
- für einen Rest der allgemeinen Formel (II)
in dem
- Q
- eine der zweibindigen Gruppen -CH2-CH2-, -CH2-CH2-CH2-, -CH=CH-,
oder
- R
- ein gegebenenfalls halogen- oder hydroxysubstituierter C1-C4-Alkylrest,
- R'
- ein C1-C4-Alkylrest bedeutet und R und R' gemeinsam auch einen
C4-C6-Alkylenrest bilden können,
und
der positiven Ladung des N-Atoms ein Äquivalent eines Anions X gegenübersteht, - Z
- für eine der Gruppen
worin
- Y
- eine Einfachbindung, ein O- oder S-Atom oder eine der Gruppen -CH2-, -CH2-CH2-, -CH=CH-, -OCH2- oder -SCH2- repräsentiert;
- R1
- Wasserstoff, OH, C1C4-Alkoxy oder C1-C4-Alkyl, welches gegebenenfalls durch Hydroxy substituiert sein kann;
- R2
- ein Thienyl-, Phenyl-, Furyl-, Cyclopentyl- oder Cyclohexylrest, wobei diese Reste auch methylsubstituiert, Thienyl und Phenyl auch fluor- oder chlorsubstitueniert sein können,
- R3
- Wasserstoff oder ein Thienyl- oder Phenylrest, der gegebenenfalls durch
Halogen oder
C1-C4-Alkyl substituiert sein kann, bedeuten,
und ferner dadurch gekennzeichnet, daß das langwirksame β-Mimetikum ausgewählt ist aus der Gruppe Bambuterol, Bitolterol, Carbuterol, Clenbuterol, Fenoterol, Formoterol, Hexoprenalin, Ibuterol, Pirbuterol, Procaterol, Reproterol, Salmeterol, Sulfonterol, Terbutalin, Tolubuterol,
- A
- for a radical of the general formula (II) in that
- Q
- one of the divalent groups -CH 2 -CH 2 -, -CH 2 -CH 2 -CH 2 -, -CH = CH-, or
- R
- an optionally halogen- or hydroxy-substituted C 1 -C 4 -alkyl radical,
- R '
- a C 1 -C 4 -alkyl radical and R and R 'can together also form a C 4 -C 6 -alkylene radical,
and
the positive charge of the N atom is one equivalent of an anion X, - Z
- for one of the groups wherein
- Y
- represents a single bond, an O or S atom or one of the groups -CH 2 -, -CH 2 -CH 2 -, -CH = CH-, -OCH 2 - or -SCH 2 -;
- R 1
- Is hydrogen, OH, C 1 -C 4 -alkoxy or C 1 -C 4 -alkyl, which may optionally be substituted by hydroxy;
- R 2
- a thienyl, phenyl, furyl, cyclopentyl or cyclohexyl radical, these radicals also being methyl-substituted, thienyl and phenyl also being fluorine- or chlorine-substituted,
- R 3
- Is hydrogen or a thienyl or phenyl radical, optionally substituted by halogen or
C 1 -C 4 -alkyl may be substituted, mean
and further characterized in that the long-acting β-mimetic is selected from the group consisting of bambuterol, bitolterol, carbuterol, clenbuterol, fenoterol, formoterol, hexoprenaline, ibuterol, pirbuterol, procaterol, reproterol, salmeterol, sulfonterol, terbutaline, toluubuterol,
- A
- für einen Rest der allgemeinen Formel (II)
in dem
- Q
- eine der zweibindigen Gruppen -CH = CH-, -CH2-CH2- oder
- R
- eine gegebenenfalls durch Fluor oder Hydroxy sustituierte Methyl-, Ethyl, oder Propyl-Gruppe,
- R'
- Methyl, Ethyl oder Propyl, bevorzugt Methyl,
und
der positiven Ladung des N-Atoms ein Äquivalent eines Anions X ausgewählt aus der Gruppe bestehend aus Chlorid, Bromid und Methansulfonat, bevorzugt Bromid gegenübersteht, - Z
- für eine der Gruppen
worin
- Y
- eine Einfachbindung, oder ein O-Atom repräsentiert;
- R1
- Wasserstoff, OH, Methoxy, Ethoxy, Propoxy, Methyl, Ethyl, Propyl, Hydroxymethyl, Hydroxyethyl oder Hydroxyypropyl;
- R2
- ein Thienyl-, Phenyl-, oder Cyclohexylrest, wobei diese Reste auch methylsubstituiert, Thienyl und Phenyl auch fluor- oder chlorsubstituiert sein können,
- R3
- Wasserstoff, oder ein Thienyl- oder Phenylrest, der gegebenenfalls durch Fluor, Chlor oder Methyl substituiert sein kann, bedeuten,
- A
- for a radical of the general formula (II) in that
- Q
- one of the divalent groups -CH = CH-, -CH 2 -CH 2 - or
- R
- a methyl, ethyl or propyl group optionally substituted by fluorine or hydroxy,
- R '
- Methyl, ethyl or propyl, preferably methyl,
and
the positive charge of the N atom is one equivalent of an anion X selected from the group consisting of chloride, bromide and methanesulfonate, preferably bromide, - Z
- for one of the groups wherein
- Y
- represents a single bond, or an O atom;
- R 1
- Hydrogen, OH, methoxy, ethoxy, propoxy, methyl, ethyl, propyl, hydroxymethyl, hydroxyethyl or hydroxypropyl;
- R 2
- a thienyl, phenyl, or cyclohexyl radical, these radicals also being methyl-substituted, thienyl and phenyl also being fluorine- or chlorine-substituted,
- R 3
- Is hydrogen, or a thienyl or phenyl radical which may optionally be substituted by fluorine, chlorine or methyl, mean
A für einen Rest der allgemeinen Formel (II)
- Q
- eine der zweibindigen Gruppen -CH = CH-, -CH2-CH2- oder
- R
- Methyl oder Ethyl;
- R'
- Methyl,
und
der positiven Ladung des N-Atoms ein Äquivalent des Anions X = Bromid gegenübersteht,
- Y
- ein O-Atom;
- R1
- Wasserstoff, OH oder Hydroxymethyl;
- R2
- ein Thienyl-, Phenyl-, oder Cyclohexylrest;
- R3
- Wasserstoff, Thienyl oder Phenylrest,
A is a radical of the general formula (II)
- Q
- one of the divalent groups -CH = CH-, -CH 2 -CH 2 - or
- R
- Methyl or ethyl;
- R '
- Methyl,
and
the positive charge of the N atom is one equivalent of the anion X = bromide,
- Y
- an O atom;
- R 1
- Hydrogen, OH or hydroxymethyl;
- R 2
- a thienyl, phenyl, or cyclohexyl radical;
- R 3
- Hydrogen, thienyl or phenyl radical,
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| EP05008960A EP1570861A3 (en) | 1999-05-12 | 2000-05-03 | Pharmaceutical compositions based on anticholinergically effective compounds and beta-mimetics |
| EP10183369A EP2269647A3 (en) | 1999-05-12 | 2000-05-03 | Pharmaceutical compositions based on anticholinergically effective compounds and beta-mimetics |
| EP10180233A EP2266621A3 (en) | 1999-05-12 | 2000-05-03 | Pharmaceutical compositions based on anticholinergically effective compounds and beta-mimetics |
| EP10183392A EP2266620A3 (en) | 1999-05-12 | 2000-05-03 | Pharmaceutical compositions based on anticholinergically effective compounds and beta-mimetics |
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| DE19921693 | 1999-05-12 | ||
| EP00929478A EP1178832B1 (en) | 1999-05-12 | 2000-05-03 | Novel medicament compositions, based on tiotropium bromide and salmeterol |
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| EP00929478A Expired - Lifetime EP1178832B1 (en) | 1999-05-12 | 2000-05-03 | Novel medicament compositions, based on tiotropium bromide and salmeterol |
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| EP10183369A Withdrawn EP2269647A3 (en) | 1999-05-12 | 2000-05-03 | Pharmaceutical compositions based on anticholinergically effective compounds and beta-mimetics |
| EP05008960A Withdrawn EP1570861A3 (en) | 1999-05-12 | 2000-05-03 | Pharmaceutical compositions based on anticholinergically effective compounds and beta-mimetics |
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